Trends in Infusion Administrative Practices in US Health Care Organizations: An Exploratory Analysis.

While specialized infusion clinical services remain the standard of care, widespread curtailing and disbanding of infusion teams as a cost-cutting measure has been documented in health care organizations for nearly 2 decades. Owing to this trend, as well as recent government interventions in medical error control, the authors engaged in an exploratory study of infusion administration practices in the US health care industry. This article presents the authors' exploratory findings, as well as their potential implications.

Outpatient parenteral antimicrobial therapy in a changing NHS: challenges and opportunities.

Up to 4% of inpatients are in hospital solely to receive intravenous antimicrobial therapy. Outpatient parenteral antimicrobial therapy (OPAT) offers the opportunity for improved efficiency and patient choice through early discharge from hospital or admission avoidance, while maintaining quality of care. OPAT aligns well with key priorities in the new NHS and in this article I explore how new developments in the national healthcare context might be exploited to promote the ongoing evolution of OPAT in the UK.

Self-infusion programmes for immunoglobulin replacement at home: feasibility, safety and efficacy.

This review of the currently available literature from more than two decades of clinical experience with self-infusions of immunoglobulin at home provides evidence to support the feasibility, safety, and efficacy in all age groups. Self-infusions at home not only increase patient confidence and their understanding of the immune deficiency but also contribute to the improvement of health-related quality of life. Such home therapy programs should be encouraged, and wherever possible, experienced centers should extend their services to include patients who require immunoglobulin therapy for immunomodulation. Home therapy programs play an important role in long-term health outcome.

Developing a strategic approach for IV therapy in the community.

The development of home intravenous therapy (IVT) services is of benefit to patients and organizations, particularly as it can facilitate early discharge from hospital or avoid hospital admission. However in providing an IVT education/refresher programme to local primary care trusts, we have found that not all of them, by their own admission, could engage in the expansion of IVT services as they did not have measures in place to support robust service delivery. Building on the authors' recent experience of assisting staff, via an education/refresher programme, to update their services, this article offers direction to other PCTs who may be struggling to update their services in times of reform and unprecedented change within the health service.

Advances in colon cancer chemotheapy: nursing implications.

Adjuvant chemotherapy for colon cancer has changed significantly during the past 5 years. The traditional agent fluorouracil has been joined by new drugs, including capecitabine, irinotecan, oxaliplatin, and targeted agents such as bevacizumab and cetuximab. These new agents bring different mechanisms of action, different side effects, and new home care nursing implications. Significant improvements in disease-free remissions and survival rates are among the many benefits of these therapies to persons with colon cancer. This article covers these newer agents, targeted therapies for colon cancer, and associated nursing and patient implications, including detailed drug information.

[The present and future of home care chemotherapy for patients with advanced and recurrent colorectal cancer].

PURPOSE: If the chemotherapy at home is as effective as the chemotherapy at an outpatient clinic, QOL of the patients will be improved. In this paper the future of chemotherapy at home was clarified from the outcome of the chemotherapy for advanced and recurrent colorectal cancer. METHOD: Hepatic arterial infusion chemotherapy (HAI) (5-FU 2,000 mg/w, continuous infusion for 7 days, n=123) for unresectable liver metastases and FL chemotherapy (5 FU 1,500 mg + l-LV 375 mg/w, continuous systemic chemotherapy for 7 days, n=32) for extra hepatic recurrence were carried out at home by a portable pump system every other week. RESULTS: The response rates were 61.2% in HAI and 18.8% in FL. MST were 14.7 months in HAI and 10.8 months in FL. It was important to establish a surveillance network system to continue the chemotherapy at home. CONCLUSIONS: It was suggested that the chemotherapy at home was effective and to maintain the patient's QOL as one of the options.

The changing face of Canadian home parenteral therapy.

This article describes the Calgary Health Region Home Parenteral Therapy Program (HPTP), which has successfully shifted infusion therapies such as anti-infectives, analgesics, hydration, vasodilators, glucocorticoids, and iron-chelating agents from the hospital to patients' homes. Particular attention is given to the parenteral administration of anti-infectives, which currently accounts for more than 95% of program adult therapy days.

Outpatient parenteral antibiotic therapy: evolution of the Calgary adult home parenteral therapy program.

In the past 25 years, outpatient antibiotic therapy has been recognized as a cost-effective, safe and patient-accepted means of managing patients with chronic infections who require prolonged parenteral therapy but otherwise do not need admission to hospital. We describe the home parenteral therapy program in Calgary, which reflects the next generation of outpatient antibiotic therapy in Canada because of its unique inclusion of patients with acute infections. The Calgary home parenteral therapy program has evolved from a few, small, single-site programs to a multisite, region-wide program that each year treats thousands of patients who require long- and short-term parenteral therapy. With escalating health care budgets and increased demand on acute-care hospital beds, existing programs in other centres may benefit from the Calgary experience, and this home parenteral therapy model may serve as a template for developing new outpatient antibiotic therapy programs in other regions.

[Home infusion therapy system from a resident's point of view].

We started a new home infusion therapy system in July 1999. The home infusion therapy system is made up of doctors, nursing stations, and pharmacies in the community. We coordinate these parties before patient discharge from our hospital and support them when the patient needs hospitalization (for example, he or she develops pneumonia). This report discusses past experiences and future issue.

Intravenous immunoglobulin use in pediatric patients.

New trends in home intravenous therapy for the pediatric population are being developed. One trend in particular is proving to be both exciting and promising. This trend is the use of intravenous immunoglobulin in the homecare setting. This article explores the most commonly seen disorders and treatments using this specific intravenous prescription. Safe nursing practice and future trends also are discussed.

High-tech home care.

The past 20-25 years have seen innovations in equipment and drugs that have allowed infusion services to move from institutions to the home. The home care industry moved into the HDIT field, considering this a natural direction in which to develop. High-tech home care is now a substantial aspect of the industry.

Home care. An emerging solution to the healthcare crisis.

As the nation's policy makers and healthcare professionals have wrestled with changing the fundamental way that medical care is delivered in this country, they have considered many options. Home care is one option that should be considered seriously. It is one of the fastest growing segments of the U.S. healthcare system because it's cost-effective, improves patients' quality of life, and can efficiently treat patients with a broad range of medical conditions.